Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 4962 | SC |
NPI | 1144269473 |
---|---|
Provider Name | Dr. Stacy L Fritz |
First Address | Columbia, SC 29201-1563 |
Second Address | Columbia, SC 29208-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 01/10/2009 |